Overview

• Values of 120–139 mmHg systolic or 80–89 mmHg diastolic are now labeled pre‑hypertension, with normal defined as below 120/80 and hypertension remaining at ≥140/90.
• Initial management in the pre‑hypertension range prioritizes lifestyle changes, with medication reserved for ≥140/90 or for 130–139/80–89 after three months in high‑risk patients.
• All treated patients should target blood pressure below 130/80 mmHg, with preference for low‑dose two‑drug combinations, often as single‑pill options.
• The guideline adopts the PREVENT 10‑year cardiovascular risk score to tailor the intensity of prevention and aligns Brazil with recent European and U.S. recommendations.
• A new chapter for the public health system (SUS) guides primary care using available medicines and MAPA/MRPA monitoring, and the document stresses evidence of modest event reductions with intensive control alongside higher risks such as renal events and hypotension.